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April 7, 1999

Method of Physician Payment and Patient Trust—Reply

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor


Copyright 1999 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.1999

JAMA. 1999;281(13):1173. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-13-jbk0407

In Reply: Our measure of patient trust was based on the Trust-in-Physician scale.1 In a pilot study,2 we modified that scale by rewording items so that they refer to the patient's physician, deleted items we thought were indicators of the consequences of trust rather than trust itself, and added items to capture theoretical dimensions of patient trust that we thought were not covered well in the original scale. We assessed the face validity with physicians, health care administrators, patients, and survey researchers not associated with our research team. Construct and criterion validity of a draft scale in the pilot study were good. However, factor analyses and other standard psychometric techniques indicated that the responses to the questions were not consistent with our hypothesized dimensions of trust. The scale was unidimensional and had high internal consistency (coefficient α) of .90.

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